Educating patients is one of the most crucial roles we play as clinicians, whether we're talking about the value of diet and exercise, the importance of vaccinations, or the adverse effects of medications. I recently became acutely aware of a very important topic we need to discuss with our patients, especially adolescents—the dangers and potentially lethal consequences of bad driving behavior.

It was a typical Saturday morning of running errands. I was stopped, my car's left blinker on in preparation for entering the dry cleaner's parking lot. I heard a horrible screeching of brakes and looked in my rearview mirror. Almost instantly, I felt a tremendous impact. Miraculously, I wasn't injured, but my car didn't do so well. Its entire back end was accordioned up against the back seat—a total loss. As my demolished car was being towed, the policeman came to speak with me.

“Well,” he said, “the driver who hit you was probably only going 5 miles per hour above the speed limit. The tire tracks on the road indicate that at least he tried to stop. Therefore,” he added, “I'm going to call it driver inattention.”

Driver inattention? What sort of understatement or euphemism is that? It sounds innocuous enough until you consider the possible outcomes. To be perfectly honest, I've probably been an inattentive driver myself from time to time. Haven't you? I may even have come close to rear ending someone else's car. On that sunny morning, I was vividly reminded that automobiles are more than a mode of transportation. They can also be thousands of pounds of hurtling metal.

The National Highway Traffic Safety Administration (NHTSA) estimates that at least 25% of police-reported crashes involve some form of driver inattention.1 Driver distraction, one form of inattention, is a factor in more than half of these crashes. Just imagine the mortality or morbidity associated with more than 1.5 million collisions a year; that's more than 4,300 crashes each day!1

Specific distractions have changed over time, reflecting the increased communication technology used both inside and outside of cars. The “old standard” of driver distractions included talking to passengers, eating, drinking, lighting cigarettes, applying makeup, and listening to the radio. Today, talking on a cell phone, the most frequent use of technology while driving, is not the only culprit, but it's a big one.

More than 100 million US motorists use cell phones while driving,2 and it increases their chance of getting into a crash by a whopping 400%.1 The NHTSA estimates that at any given moment during daylight hours, 8% of all drivers are talking on a cell phone. Although cleaning the inside of your windshield, reaching for a piece of paper, or breaking up a fight between your kids all serve as distractions, talking on your cell phone—even a hands-free variety—seems to trump all other distractions.

A recent study showed that motorists who talk on handheld or hands-free cellular phones are as impaired as drunken drivers.2 Frank Drews, an assistant professor of psychology and co-author of the study, remarked, “We found that people are as impaired when they drive and talk on a cell phone as they are when they drive intoxicated at the legal blood-alcohol limit of 0.08 percent, which is the minimum level that defines illegal drunken driving in most US states.”2

As communication technology has evolved, so, too, has driver distraction—making and answering telephone calls, setting and listening to the GPS, and returning e-mails on a Blackberry. Text messaging while behind the wheel has also become more widespread, especially among teens younger than 18.3 According to a survey conducted by AAA, 46% of drivers between the ages of 16 and 17 say they text message while driving.3 A recent example of the tragedy that can follow occurred in New York State this past summer, when five recent high school graduates were killed on the road.4 Text messages were sent and received on the 17-year-old driver's cell phone moments before her SUV slammed head-on into a truck and burst into flames. The driver's inexperience at the wheel, evidence she was driving above the speed limit at night on a winding, two-lane highway, and a succession of calls and text messages on her phone were cited as possible factors in the crash.4

Picture this: It's 2 AM and the telephone jangles you awake. A voice from the state police tells you that your child has been in a car accident and you are about to hear the outcome. Now imagine the extraordinary opportunity you have when speaking with teens or their parents to hopefully prevent that nightmare from coming to pass. JAAPA

REFERENCES

1. Traffic safety. Distracted driving. Cyberdriveillinois Web site. http://www.cyberdriveillinois.com/departments/drivers/traffic_safety/distracted.html. Accessed September 11, 2007.

2. Drivers on cell phones are as bad as drunks. What's new at the U? University of Utah News Center. http://unews.utah.edu//?r=062206-1. Accessed September 11, 2007.

3. Gaug A. A dangerous distraction: text messaging behind the wheel. Vindy.com. http://www.vindy.com/content/local_regional/307388542519036.php. Accessed September 11, 2007.

4. Dobbin B. Cell phone use may have been factor in crash. Star-Gazette.com. http://www.stargazettenews.com/apps/pbcs.dll/article?AID=/20070714/NEWS01/707140327. Accessed September 11, 2007.